Making the Data fit the Hypothesis is not Science: The American Society of Addiction Medicine (ASAM), “Weasel Phrases,” “Framing” and “Data-Dredging.”

Principles of Addiction Medicine devotes a chapter to Physician Health Programs. Written by Paul Earley, M.D., FASAM,1 Earley states that the lifetime prevalence of substance abuse or addiction in physicians found by Hughes2 is “somewhat less than the percentage in the general population reported by Kessler” of 14.6%.3

Although he specifies the numerical percentage “in physicians at 7.9%,”3 he avoids the use of numbers (14.6%) in the general population. He instead uses the qualifier “somewhat less.” Why is this?

My guess is because it understates the statistical fact that the prevalence found by Kessler in the general population was almost twice that found by Hughes in physicians.

You see, “Somewhat less” is a “detensifier.” It creates an impression of a small disparity between doctors and the general population.

In propaganda this is what is known as a “weasel phrase.” Weasel phrases are used to obfuscate the truth. Weasel phrases mislead those either without the time, or without the sense to see or look any deeper. The problem is it works.

“Methodologic differences may account for this difference,” Earley states, as the Hughes study “surveyed 9, 600 physicians by mail” and “relied on honest and denial-free reports by the physicians; the Kessler study utilized face-to-face interviews with trained interviewers.”1

This is an example of language framing. Language framing uses words and phrases to direct attention to a point of view to advance a vested interest.

In this case the use of the phrase “honest and denial free” in the context of physician reporting imparts associative meaning to the reader.

As denial is a recurring motif and cardinal attribute of physician addiction according to the paradigm, the connotation is that the reports by physicians may have been influenced by dishonesty and denial while face-to-face interviews done by “trained” interviewers were not.

“Framing” is another propaganda technique designed to tell the audience how to interpret the information given through context. The message here is that the somewhat less lifetime prevalence of substance abuse and addiction in physicians found by anonymous mail survey may be underreported as a result of both methodology and denial.

But in actual fact there is a large body of research regarding “social desirability bias” that shows the converse to be true.

One of the most consistent findings of studies of this kind is that socially desirable responding is significantly more likely with face-to-face administered data collection compared with self-administered anonymous modes.4-6

Tourangeau et al. reviewed seven studies comparing self-reports of drug use in surveys conducted in different modes. For each estimate obtained in the studies they calculated the ratio of drug use reported in self-reported surveys to the corresponding estimates in interviewer administered surveys and found that 57 of 63 different comparisons showed higher levels of reporting of drug use in the self-reported mode.7

The principal cause of social desirability bias is the level of perceived anonymity of the reporting situation.7

Evidence-based research does not support Earley’s claim that methodological differences in study design explain the difference in reported lifetime prevalence of substance abuse or addiction between physicians and the general population in these two studies.

Evidence based research would, in fact, make the findings more robust.

Moreover, I find it hard to comprehend the psychodynamics, motivation, and logic of denial and dishonesty in influencing an anonymous survey. So too would anyone else who dare peer beneath the veil. It is, in fact, a Potemkin village. In reality the emperor has no clothes.

6 thoughts on “Making the Data fit the Hypothesis is not Science: The American Society of Addiction Medicine (ASAM), “Weasel Phrases,” “Framing” and “Data-Dredging.””

Reblogged this on 61chrissterry and commented:
If this is proved to be true, then it could well throw doubt on other research results. When stating research results all data should be produced, otherwise is there someting to hide.

Keep at it. We need to encourage many people to speak out, especially victims who have been there. I am not a healthcare provider as you know but I do know that most psych “care” including addition “care” is bogus. I have been to very dark places.

This is an example of language framing. Language framing uses words and phrases to direct attention to a point of view to advance a vested interest.

In this case the use of the phrase “honest and denial free” in the context of physician reporting imparts associative meaning to the reader.

As denial is a recurring motif and cardinal attribute of physician addiction according to the paradigm, the connotation is that the reports by physicians may have been influenced by dishonesty and denial while face-to-face interviews done by “trained” interviewers were not.

“Framing” is another propaganda technique designed to tell the audience how to interpret the information given through context. The message here is that the somewhat less lifetime prevalence of substance abuse and addiction in physicians found by anonymous mail survey may be underreported as a result of both methodology and denial.

But in actual fact there is a large body of research regarding “social desirability bias” that shows the converse to be true.

Thank you for this post. I have followed this site without comment for a short period of time.

I am another MD who has run afoul of this system. I have been “silent and afraid” for all the reasons you have so eloquently stated. This particular subject, however, compels me to at least begin to add my voice to what you are doing. I plan to continue to follow closely and contribute whenever possible. As you know, it can be very tricky and these health care “professionals” don’t seem to operate according to the same exacting standards as the rest of us.